Individual provider Active NPI

Robert Wojtanowski

  • Emergency Medicine Physician
  • Etowah, TN
National Provider Identifier
1912946690
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
29941 Issued in TN
Practice address
886 Highway 411 N
Etowah, TN 37331-1912
Phone
(423) 263-3600
Fax
(423) 263-3601
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 29941 TN Primary

Addresses

Primary practice location

886 Highway 411 N
Etowah, TN 37331-1912

Mailing address

3211 Shannon Rd
Suite 300
Durham, NC 27707-6322
Phone (919) 403-2028

Other identifiers 3

IdentifierTypeStateIssuer
4194067OtherTNBCBS
1507293MedicaidTN
P00667677OtherTNRAILROAD MCARE THRU AMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000252 TN Practitioner - Family PracticePractitioner - Emergency Medicine 4587636261 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29941TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 5, 2014 Accepting new patients
Concord Medical Group of Kentucky PLLC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Rhea Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Rhea Medical Center Current Accepting new patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Mar 1, 2017 Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Lakeway Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

9400 Rhea County Hwy
Dayton, TN 37321
Phone (423) 285-5220

886 Highway 411 N
Etowah, TN 37331
Phone (423) 263-3600

436 Central Ave W
Jamestown, TN 38556
Phone (931) 752-5762

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

726 McFarland St
Morristown, TN 37814
Phone (423) 522-6160

401 Sewell Dr
Sparta, TN 38583
Phone (931) 738-2164

1602 Avenue Q
Lubbock, TX 79401
Phone (469) 809-6712

Interoperability endpoints

  • Direct secure messaging: robert.wojtanowski.1@16055.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1912946690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 SHANNON RD",
            "address_2": "SUITE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076322",
            "telephone_number": "919-403-2028",
            "fax_number": "919-419-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 HIGHWAY 411 N",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311912",
            "telephone_number": "423-263-3600",
            "fax_number": "423-263-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJTANOWSKI",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "29941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4194067",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507293",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE THRU AMS",
            "identifier": "P00667677",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Etowah, TN

Sources for this page

Verify at the official NPI Registry.